Rehabilitation after removal of colon polyps. Features of the diet after removal of intestinal polyps by colonoscopy. Video: endoscopic removal of intestinal polyps

28.04.2024

Polyps in the intestine are benign formations, often localized in various parts of the intestine, as well as in other hollow organs. They are formed from the intestinal wall, from its glandular epithelium, and then grow into its lumen. The formations sometimes rest on a stalk, and sometimes it is absent, and the polyp rests on a broad base.

Polyps are classified as precancerous diseases, since they often become malignant (especially in the hereditary form of polyposis). Therefore, when they are detected in the intestines, doctors definitely recommend surgical removal. The difficulty in diagnosing the disease lies in the fact that polyps give mild symptoms, although sometimes it is possible to suspect their presence based on a number of clinical signs (bloating, constipation, itching in the anus and some others).

The consistency of the formations is soft; as for their shape, it can be varied: spherical, branched and mushroom-shaped. Most often they form in the rectum or lower colon. In the higher parts of the colon, polyps form extremely rarely. So, only in 0.15% of cases they are detected in the duodenum. Their color varies and can be dark red, reddish-gray, or with a yellow tint. Sometimes mucus is found on the surface of the polyp.

As for statistics, intestinal polyposis is a common disease. About 10% of people over the age of 40 have tumors in the intestines. Moreover, in men they form 1.5 times more often. The sooner the pathology is identified, the higher the chances of preventing its malignancy. It often helps to do a stool test for occult blood. When an operation is carried out in a timely manner, in 90% of cases it becomes the key to a person’s survival.

Symptoms of polyps in the intestines

It is often impossible to suspect the presence of a polyp based on certain symptoms, which is due to the lack of specific clinical manifestations of the pathology. The degree of their severity depends on the size of the formations, where exactly in the intestine they are located, and also on whether they have become malignant or not.

Possible symptoms of intestinal polyps include:

Discharge of mucus and blood, which is most often observed when diagnosing villous adenomas.

If the polyps are of impressive size, the patient complains of periodic pain that is cramping in nature. They occur in the lower abdomen. In addition, mucus and blood are observed, and constipation occurs, which occurs as an intestinal obstruction. Often, with large polyps, a person experiences a sensation of a foreign body in the anus.

In parallel with polyps, the patient often has other pathologies of the digestive tract, which force him to undergo a full examination; it is during this that a neoplasm is accidentally discovered.

The development of colorectal occurs 5-15 years after the formation of a villous adenomatous polyp. Malignancy occurs in 90% of cases.

Obvious symptoms of polyps are constant disturbances in peristalsis. This may include diarrhea and constipation. The larger the formation, the more often constipation occurs, as the intestinal lumen decreases. As a result, partial intestinal obstruction is formed.

The patient may experience a feeling of fullness in the stomach, suffer from belching and nausea.

When pain appears in the intestinal area, the onset of an inflammatory process can be suspected.

An emergency reason to see a doctor is the onset of bleeding. Blood is released from the anus. This is a fairly serious symptom and may indicate a malignant process in the intestines.

If the polyp has a long stalk, then it can protrude into the anus, although this is quite rare.

Hypokalemia is the result of disruption of the intestines due to the presence of large polyps with finger-shaped processes. They secrete a significant amount of salts and water, thereby stimulating profuse diarrhea. This leads to a drop in potassium levels in the blood.

Causes of polyps in the intestines

Modern medicine does not have clear data on the etiology of polyps in the intestines.

However, there are certain theories that suggest the mechanism of their formation:

Chronic inflammation in the intestinal walls. It has been established that polyps cannot begin to form in healthy tissues. Therefore, this assumption regarding the etiology of their development seems most obvious. Inflammatory processes occurring in the mucous membrane cause tissues to atrophy faster, and the epithelium degenerates faster. In addition, scientists point to a connection between the process of polyp formation and diseases such as dysentery, ulcerative colitis, typhoid fever, enteritis, proctosigmoiditis. The reason for this is the disappearance of growths after getting rid of these diseases. In addition, constipation and intestinal dyskinesia can provoke the growth of polyps. It turned out that polypous growths are more often found in the place of the intestine where there was fecal stagnation and microtrauma.

Global health problems for the majority of the population associated with environmental degradation. It is quite difficult not to notice the deterioration in the health of the population. First of all, this concerns children. The number of children with severe pathologies is constantly increasing. Many children suffer from diseases that were previously common only in old age. In the process of polyp formation, factors such as eating foods with chemicals, physical inactivity, lack of fresh air in city living conditions, alcohol abuse, smoking, and lack of diet also have an important influence.

Pathologies of the digestive system and blood vessels. The condition of the intestinal mucosa depends on the condition of the blood vessels. Varicose and deverticular disease, atherosclerosis have a negative effect. Pathologies of the digestive system cannot but affect intestinal health.

Genetics. Genetics is believed to influence the development of the disease. This is explained by the fact that even against the background of absolute health, polyposis growths are found in children. Scientists explain this fact by a genetic program that forces some parts of the intestine to work differently.

Embryonic theory. Scientists put forward a theory that those areas of the intestine in which the formation of polyps occur were incorrectly formed during intrauterine development. Symptoms of the disease begin to appear somewhat later as a result of the influence of additional negative factors.

Food allergies, gluten intolerance. If only a few decades ago such a problem as gluten intolerance was rare, now more and more children suffer from this food allergy. When products containing this protein enter the body, the immune system begins to react violently to it. It perceives gluten as a foreign agent, which leads to damage to the mucous membrane lining the intestines. If such an immune response is ignored, a person faces serious health problems, including intestinal cancer and the development of osteoporosis.

In addition to the fact that there are theories for the development of intestinal polyps in general, scientists have put forward the most likely factors for their formation in various sections, such as:

Rarely formed polypous growths inside the duodenum most often result from gastritis with high acidity, cholecystitis or cholelithiasis. The age of such patients varies from 30 to 60 years.

Even less often, formations are detected in the cavity of the small intestine. Moreover, they are combined with polyps in other parts of the intestines and in the stomach, and are more often diagnosed in women aged 20 to 60 years. Their appearance can be triggered by multiple factors, among which the inflammatory process is the leading one.

Formations found in the colon are most often the result of heredity.

What is the probability of a polyp degenerating into intestinal cancer?

About 75% of all polypous formations found in the intestines have the ability to malignize. Such growths are called adenomatous. In order to determine the subtype of adenomatous polyp, it is necessary to examine it under a microscope. They can be tubular, glandular-villous, or simply villous. The most favorable prognosis in terms of malignancy is provided by tubular formations. Villous polyps are the most dangerous and most often malignant.

The size of the formation also influences whether a polyp is at risk of malignancy. The higher it is, the higher the risk. When the growth exceeds 20 mm in volume, the threat increases by 20%. Due to the fact that even the smallest polyps will steadily increase in size, they must be removed once detected.

There are also types of polyps that are not at risk of malignancy, these are: hyperplastic, inflammatory and hamartoma formations.

Diagnosis of a polyp in the intestine

The early development of the disease does not produce clear symptoms, so most developed countries have introduced mandatory annual stool testing to detect occult blood in it. This analysis allows you to detect even invisible blood particles that are passed along with stool during bowel movements. However, even a negative test result cannot indicate that there is no polyp in the intestine.

Techniques such as MRI and CT can detect formations in some parts of the intestine. To diagnose them in the rectum and sigmoid colon, it is more advisable to undergo sigmoidoscopy using a rectoscope. This device makes it possible to visualize the intestinal walls in more detail. In addition, proctologists recommend undergoing sigmoidoscopy every 5 years. This must be done for people over 50 years of age.

Digital examination is another way to detect polypous growths, fissures, tumors, cysts and hemorrhoids in the terminal rectum and anus.

Irrigoscopy allows visualization of formations larger than 10 mm. It is performed by injecting a contrast agent into the large intestine and taking x-rays.

However, the most modern and informative method for diagnosing polyposis is colonoscopy. It makes it possible to obtain information about any intestinal pathologies, and if a polyp is detected, it can be biopsied. The resulting biopsy is sent for histological and cytological examination.

It is important for the doctor not to mistake the polyp for another formation similar to it:

Angioma. This is a tumor that has multiple vessels and often causes severe bleeding.

Lipoma is a small tumor that often localizes to the right side of the colon.

Myoma causing intestinal obstruction. They are diagnosed quite rarely.

A non-epithelial tumor that does not have a stalk and at the same time reaches an impressive size.

Crohn's disease can cause pseudoliposis, which is found in the upper part of the large intestine.

Actinomycosis affecting the cecum.

Histology mainly helps to differentiate the type of formation.

Treatment of polyps in the intestines

After the polyp has been accurately differentiated, the doctor decides on the method of its removal. As for drug treatment, it is not practiced, since it is not capable of ridding the patient of education. In some cases, taking medications is indicated, however, this measure is temporary and allows you to prepare the patient for the upcoming operation. This is especially true for patients with weakened immune systems and the elderly.

To reduce bloating, drugs from the group of antiflatulents are prescribed, for example, Simethicone. If there is severe pain, it is recommended to take antispasmodics, for example, No-shpa.

Removal of polyps in the intestines

Regardless of the size of the formation, each of them must be removed. After this procedure, a microscopic examination is carried out to determine the presence of atypical cells.

The most popular ways to remove formations are:

Transrectal excision of the polyp

The procedure is performed using scissors or a scalpel. In this way, only polyps located close to the anus can be removed from the body. They should be in an area not exceeding 10 cm from the beginning of the anus, although a distance of 6 cm is considered optimal for such an operation.

The patient is given a local anesthetic. Most often, Novocain 0.25% is used for this. General anesthesia is used extremely rarely. After the onset of anesthesia, the doctor uses a special mirror to spread the anal canal and remove the polyp.

When the formation has a leg, a Billroth clamp is used to clamp the leg. The defect formed on the mucous membrane must be sutured. For this, a maximum of 3 knots made with a catgut seam are sufficient. It does not require removal and will completely resolve after a month. If the polyp is attached to a wide base, then it is removed by cutting it out from the area of the healthy mucous membrane using an oval incision.

In the case when the formation is located further than 6 cm, but closer than 10 cm from the beginning of the anus, the surgical technology is slightly modified. Using a rectal speculum, the anal canal is opened and further stretched with the fingers until it is completely relaxed. Then a larger speculum is inserted, allowing the bowel wall to be removed without the polyp. Then a short speculum is inserted, and the patient needs to push. This allows the formation to be brought closer and gives the doctor the opportunity to grasp it using an extended Billroth forceps or a fenestrated forceps. The doctor removes the short speculum, injects additional anesthesia into the base of the polyp, and then removes it.

Endoscopic polypectomy

This method of polyp removal is advisable to use if the formations are located in the middle (proximal) parts of the intestine. This surgical intervention is classified as a minimally invasive surgical method that can be performed while the patient is in a state of medicated sleep. During the procedure, an endoscope is inserted into the anus, with which a polyp is found. After its detection, the formation is removed using endoscopic instruments. The doctor then makes sure there is no bleeding and, if necessary, performs recoagulation. The polyp is removed from the patient's body using an endoscope.

If the formation is large, then it must be removed not entirely, but in parts. This procedure is called biting. This is a rather complex technique, during which an explosion of intestinal gases can occur, as well as perforation of the intestinal wall if the burn is too severe. Therefore, only a specially trained proctologist or endoscopist can perform such an operation. After removal of a large formation exceeding 20 mm, the patient needs a repeat endoscopy a year later. A person is not removed from the proctologist’s register and must undergo this procedure every 3 years, aimed at identifying a possible relapse of the disease.

Electroexcision

A proctoscope is inserted into the rectal cavity. An electric loop is passed along it to the polyp. She pounces on the polyp, and current passes through her. The temperature of the loop increases, the epithelial tissue of the formation heats up. As a result, the tumor receives a thermal burn and dies. When the loop is tightened, the formation is cut off and brought out.

This method has a number of advantages, first of all, it allows you to prevent the development of bleeding, since instant coagulation of blood vessels occurs.

Colotomy or resection

The operation is indicated when polyps are detected in the sigmoid colon, as well as when diagnosing fleecy formations that have a wide base. This will require general anesthesia. Then the doctor makes an incision in the left iliac region and the intestine is removed into the resulting lumen. The polypous area is palpated and opened. Previously, restrictive soft presses are applied to healthy areas. The tumor and the part of the mucous membrane on which it is located are excised, then sutures are applied to this place. The intestine itself is sutured in two rows, and the anterior abdominal wall is sutured in layers.

Enterotomy

A surgical intervention aimed at removing polyps that are small in size and attached to a stalk. Depending on which part of the intestine has undergone pathological growth, duodenotomy (duodenum), ileotomy (ileum), jejunotomy (jejunum) are distinguished. The required part of the small intestine is dissected using a scalpel or electric knife, the polyp is removed, and the resulting hole is sutured. The operation most often does not lead to complications, since the lumen narrows slightly during standard enteromy.

Segmental resection of the small intestine

The operation is indicated when large polyps are detected in the small intestine or if their base is wide. The area in which it is localized is excised. The ends of the intestine come together and an interintestinal anastomosis is formed. Often such an intervention causes digestive problems in the future, as the patient suffers from “short bowel syndrome.”

As for the prognosis for recovery, it is favorable if the formation was detected in the early stages and promptly eliminated from the body. The longer a polyp stays in the intestine, the larger its size, the greater the number, the higher the risk that the formation will degenerate into a malignant tumor. The probability of relapse remains quite high even after complete removal of the tumor, it is up to 30%. Therefore, it is so important to follow up with the patient and undergo regular examinations.

Diet after removal of intestinal polyps

The patient’s rehabilitation after surgery primarily depends on his compliance with the diet. It consists of several stages and must follow certain rules.

After the operation, the first stage of the diet begins. It lasts for 3 days after the intervention. The patient is not allowed to drink or eat food for the first 24 hours. When this time is up, the person will be able to quench his thirst. The maximum volume of liquid taken at one time should not exceed 50 ml. In addition, the patient can drink vegetable broth or compote based on unsweetened fruits. After another 12 hours, rice water, weak meat broth or jelly are allowed. You can also diversify the patient’s strict menu after surgery with rosehip decoction. Such restrictions are due to the fact that it is necessary to eliminate as much as possible the motor activity of the intestine and reduce its excretory function. The bile and digestive enzymes produced can negatively affect the condition of sutures and damaged tissues.

The second stage of the diet starts three days after the intervention. If the patient feels satisfactorily, then his diet can be expanded by introducing liquid porridges, meat soufflé (from lean meat), mucous soups and soft-boiled eggs. As for cereals, preference should be given to millet, oatmeal and rice. When a new product is introduced to a patient after surgery, you should monitor his well-being extremely carefully. If, after ingesting a particular product, increased gas formation occurs or painful sensations appear, then it is important to refuse such food. The second stage of the diet is aimed at consistently increasing the load on the operated intestine. At this time, the patient needs to normalize his stool. You should stick to this diet until you are discharged from the hospital.

The third stage occurs two weeks after the operation. Over the next four months, the patient will have to adhere to a gentle diet.

The doctor must familiarize the patient with the basic rules of nutrition after surgery:

It is important to stick to the regime. If foods are introduced into the body at the same time, this will allow enzymes to begin to be produced in advance. In this case, the digestion process will not be so difficult for the recovering intestine.

It is worth sticking to fractional meals. This will improve intestinal motor functions and reduce the load on it. The number of meals should not be less than 6, but it is important to consume small portions.

It is important to prevent fermentation processes in the intestines, as they can cause the development of peritonitis. To do this, you should refuse to include legumes in your diet. The restrictions include nuts, asparagus and mushrooms.

To prevent constipation, the patient should receive sufficient fluids. Its volume depends on the patient’s body weight, on average it is 3 liters. First courses must be on the menu.

The fattier the food, the more bile is formed. Its excess content negatively affects the process of intestinal tissue regeneration.

It is important to avoid eating too rough foods, which can injure the intestines. Products must be either thoroughly boiled or baked.

It is worth adding dairy products, eggs and lean meat to your diet. All of them contain protein, which promotes rapid tissue restoration.

Sour, spicy and fried foods are completely prohibited. This prohibition is due to their ability to chemically irritate the intestines.

The menu should be developed and compiled in such a way that it fully meets the needs of a person recovering. This is important to do despite existing restrictions. Normal intestinal motility is the key to regular bowel movements. This helps prevent dysbiosis and constipation, and therefore to some extent reduces the risk of re-formation of polyps.

Patients must follow a diet after removal of intestinal polyps by colonoscopy. After surgical interventions on the digestive organs, table No. 0 is recommended. The nutritional characteristics within this table describe the methods of preparing dishes, the frequency of meals, and the menu. Colonoscopy is a gentle method for removing intestinal tumors. It causes minimal harm to the intestinal mucosa. However, it needs regeneration, that is, a time when digestive juices and foods will irritate it as little as possible.

For diseases of the gastrointestinal tract (gastrointestinal tract) and intervention on its individual organs (for example, after excision of polyps), moderate and split meals are recommended. This means that food should be consumed 6-8 times a day in very limited portions.

The dishes themselves should be gentle:

chemically;
mechanically;
thermally.

The diet after removal of polyps in the intestines is first prescribed “zero”, then sequentially tables: 2a, 2b, 2c. Diet No. 0 is prescribed for the first 2-3 postoperative days.

Its purpose:

Preventing excessive peristaltic activity of the intestinal walls.

Providing nutrition to the human body when it is difficult to digest solid food pieces.

Maximum respect for the mucous lining of the gastrointestinal tract.

Prevent gas formation.

Providing nutrition to the human body when it is difficult for the digestive system to digest solid food pieces after eliminating polypous growths of the sigmoid colon and other lower parts of the intestine.

After removal of the polyp of the rectum, colon or sigmoid, the preparation of liquid dishes and jellies is allowed. Solid foods, plant fiber in any form (even pureed), milk, and baked goods (including crackers) are excluded. The diet is low in calories and unbalanced.

The main restrictions are placed on the following ingredients:

table salt;
proteins;
fats.

Under no circumstances should you drink wine, vodka or carbonated drinks. Food should not be hot (above 40 o C) or cold (below 20 o C). The patient eats at least 7 times a day in portions of up to 300 ml. If necessary, your doctor may recommend feeding every 2 hours around the clock.

If 2-3 days after the polypectomy the condition of the operated patient has improved, the menu can be diversified.

Table assigned:

2a on days 2-3 until about 8 days after removal of colon polyps (its purpose is to reduce the load on the mucous membrane and prevent flatulence).
2b on days 9-10 after surgery for just a couple of days as a transition diet to a more balanced diet.
2c on days 12-13 after intervention in the rectum, sigmoid or colon. Its purpose is to restore intestinal functions and relieve a person of excessive gas formation. This is achieved by sharply limiting a variety of stimuli. This option is already balanced.

In the first case, the diet continues to be unbalanced, but you can already eat pureed porridge from high-quality cereals (buckwheat, oatmeal, rice). Steam omelette or soft-boiled eggs, compote are allowed. This stage involves the return of meat dishes to the diet. The meat should be boiled and lean. It could be chicken, rabbit or lean fish. You still need to eat in small portions of 300-450 ml. The temperature of the dishes is maintained as with the zero diet. Everything is prepared by steaming or boiling. Milk, raw fruits and vegetables, bread (crackers) are still not allowed. Jelly is also not recommended, this will avoid fermentation processes.

Diet therapy using table 2b allows eating 6 times a day. This is a more balanced nutrition option. With this diet, they eat pureed fruits and berries, which must be peeled and pureed. You are allowed to drink kefir, eat white crackers and steamed pureed curds. All food is thoroughly chopped and steamed or boiled. Nothing hot, spicy, fatty or salty should be present in the diet.

At the last stage described above, the use of cream or butter is allowed. It is permissible to diversify the table with mashed potatoes, slimy soups, gluten-free milk porridges, fruit jellies and jelly, freshly squeezed juices, weak broths and vegetable decoctions. Cooking is allowed only by steaming or boiling. The temperature of food should not be lower than 15 o C for cold appetizers, and hot portions - in the range of 20-50 o C. You are allowed to eat 5 times a day. But you should refrain from coarse fiber.

Contact a doctor who will conduct an examination and endoscopic examination to determine how the body is recovering and whether there are any negative phenomena.

Even after a month you cannot:

smokers return to cigarettes;
those who like to consume pickled dishes, smoked meats, sauces, all kinds of surrogates in the form of canned food;
for those with a sweet tooth - cakes, chocolate and pastries;
for those who like to drink a glass of alcohol on a holiday - to go with alcohol.

You should not eat “heavy” and gas-forming foods. It includes foods such as mushrooms, legumes, radishes, spicy vegetables (onions, garlic), turnips. You still shouldn't indulge in carbonated drinks. The doctor will tell you what diet is appropriate at this stage and, if necessary, offer medicinal support for the body, for example, enzymes, foods rich in calcium and vitamin D.

Diet after removal of an intestinal polyp is a necessary healing tool. You won’t be able to give it up quickly if you don’t want to face complications. The transition to solid food should be smooth and gradual.

For the health of the gastrointestinal tract, it is useful to completely neglect fast food, smoked meats, fried foods and sweets. Eat right, and this will protect you from relapses of the disease and many other unpleasant phenomena.

Polypous neoplasms on the intestinal walls are a common clinical picture in proctological practice. The feasibility of removal is determined by numerous criteria, including histological examination data, the volume of pathological growth, and the severity of symptoms. Many clinicians are convinced of the need for polyps at an early stage of development. Oncologists consider any neoplasm a potential precancer, so its timely removal is necessary.

After detecting a small polyp, doctors may resort to watchful waiting. Its essence lies in dynamic control over the size of the tumor and influence on symptomatic manifestations.

If the polyp does not exceed 1 cm, does not disturb the patient’s condition, or does not affect the functionality of the intestines, then periodic examinations of the tumor are carried out after a certain period of time.
If the growth remains stable, does not grow, its structure does not change, and new polypous foci do not appear, then the operation is postponed.

The key criterion for the need for removal is considered to be any change in polypous lesions.

Such changes are the main indications for removal:

Hidden and obvious bleeding (up to the development of anemia);
Symptoms of obstruction due to a growing polyp;
Deterioration of intestinal motility in the area of the polypous lesion;
Constipation, diarrhea, stool instability;
Copious discharge of mucous secretion from the anal canal;
Pain during defecation, in the peritoneal area.

Doctors also take into account the psychology of patients. Having heard the news about the stability of the pathological growth and the absence of a threat to life, many forget about the recommended regular examinations. They often seek help at an advanced stage of cancer or with serious symptoms, when emergency intervention is required. In this case, doctors warn patients about the danger and recommend timely removal. What happens if you do not remove the polyp in the intestines.

Unfortunately, conservative medicine is ineffective in treating polyps, and therefore no traditional medicine methods can completely cure the intestinal mucosa. At best, such tumors will decrease slightly in size.

Removal technique and methods used

The choice of surgical intervention method depends on various factors. Often, surgeons combine several removal methods to achieve the most positive results. An important factor in the choice of surgical tactics is the multiplicity of polyposis foci.

Thus, for single polyps, removal is possible during a diagnostic and treatment study followed by cauterization of the wound. With multiple lesions, it is often necessary to resort to radical surgical methods. If the tumor becomes malignant, surgeons can remove part of the intestine.

The following effective methods of removal are distinguished depending on the nature of the polyp and the risks of its malignancy.

Endoscopic standard operation

Endoscopic polypectomy is used for benign growths localized in the middle parts of the intestinal tract. The method refers to minimally invasive interventions in relation to the intestinal lumens. The surgery is performed under local anesthesia.

The tactics of surgical manipulation have the following algorithm:

Insertion of an endoscopic probe to the location of the growth;
Fixation of a passive electrode (special lead plate) at the lower back;
Insertion of a special endoloop through the biopsy channel;
Tightening the pathological growth with a loop and cutting it off;
Simultaneous cauterization of the wound surface with current to avoid bleeding;
Hemostasis control;
Carrying out additional coagulation;
Extraction of the removed growth for further histological examination.

For large polyps, biting tactics are used, crushing the polyp and removing it in parts. This is necessary to prevent burns to the mucous membrane, since a wide wound bed requires prolonged cauterization. Instead of an endoloop, in this case biopsy forceps are used. Lumping is also used for multiple polyps, when they are closely located among themselves.

The operation is performed under the guidance of a proctologist, endoscopist or general surgeon.

On a note! After removal of large villous polyps, a mandatory endoscopic examination is carried out after 6-8 months.

Laparotomy of polyps

Laparotomy is a method of surgery with an incision in the peritoneum to provide access to the abdominal organs. Used when it is impossible to use endoscopic methods for removing polyps. Effective against polypous lesions with a wide base. A similar method is colotomy to remove polyps in the sigmoid colon.

After the incision, the intestine is removed and the possible location of the polyp is probed;
The wall of the organ is dissected and the tumor is completely removed within healthy tissue;
After excision, sutures are placed on the mucous membranes, intestinal walls (double suture) and peritoneum (a blind layer-by-layer suture is used).

The operation is performed under general anesthesia in a hospital setting. The method has many contraindications and complications. After laparotomy, patients undergo a long recovery period.

Laparoscopic method

Laparoscopy is a modern surgical method that requires small incisions up to 1.5 cm in the peritoneum. The method is recommended for polyps larger than 2.5 cm. Unlike full abdominal operations, when large incisions are required, laparoscopy involves punctures for the introduction of laparoscopic instruments.

The operation is performed under general anesthesia. After removal of the polyp, it is sent for histological examination to assess the nature of the tumor, its structure and tendency to malignancy.

The recovery period is quite long. The method has many contraindications and is used only for special indications.

Laser removal

The use of laser in surgery is a new direction, the popularity of which is due to its absolute bloodlessness, minimally invasiveness, efficiency and the possibility of removal in one visit. Suitable for removing small polyps without a tendency to malignancy according to histology results.

The total duration of the procedure does not exceed 30 minutes. Laser removal occurs using endoscopic equipment. Under the influence of a laser beam, the growth tissue and its base are literally evaporated, excess moisture is eliminated, and the vessels are sclerosed.

The main advantages are considered:

Less tissue damage;
Local effect only on the polyp itself;
No recovery period.

Attention! Among the disadvantages are:

restrictions on the volume of the polyp;

increased smoke during manipulation;

difficulty in clear visualization;

high cost of the operation.

Resection of intestinal sections

Resection is a method of surgical intervention in which the surgeon cuts off part of the damaged organ within healthy tissues and then connects them to restore the previous integrity.

Resection of the intestine for polyps is a radical method, which is used only in extreme cases:

Serious complications caused by polyps;
Confirmation of histological analysis for atypical cells;
Tumor malignancy;
Perforation of the intestinal walls in the area of the growth and its ingrowth into other tissues outside the organ.

Also, resection is indicated in case of crowded arrangement of several polyps at once.

The procedure has several varieties, and the tactics are chosen based on the location of the pathological growth:

Frontal resection. It is performed when the polypous lesion is located above 10-12 cm from the anus. During the manipulation, part of the sigmoid and rectum is removed, followed by anastomosis. The operation is organ-saving; the patient retains natural bowel movements, erectile function, and urination. The nerve endings are not damaged during the operation and are not intersected in any way.
Low frontal resection. It is performed if the growth is located 5-12 cm from the anal sphincter. Surgery involves complete removal of the rectum and sigmoid colon flap while preserving the anal canal. In the first stage of the operation, the intestine is brought out into the anterior part of the peritoneum to prevent feces from entering the healing area of the intestine. In the second stage, the colostomy is closed to allow natural bowel movements through the anus.
Abdominoanal resection. It is used when the polypous lesion is localized at a distance of 6 cm from the anal sphincter. During the operation, part of the sigma, the entire rectum, and a segment of the anus are resected, followed by the formation of a stoma (an opening of the intestine that is formed surgically). 3 months after healing, the stoma is closed, and the patient relieves himself naturally.
Abdominoperineal removal. The operation is performed when the tumor is localized in the area of the anal sphincter ring or 1 cm away from the anus. The most traumatic procedure without the possibility of closing the stoma. During the operation, part of the sigmoid colon, the entire rectum, the entire anus, along with the sphincter and part of the pelvic muscle structures are completely removed.

When polyps are localized in the small intestine, two main methods of surgical intervention are performed, which are associated with serious complications and a long recovery period:

Enterotomy. The method involves opening the lumen of the small intestine through the abdominal cavity. Polyps are removed, and the wound surface is completely sutured tightly.
Segmental resection. The method involves an open or laparoscopic approach followed by the formation of a temporary stoma and its closure after some time.

After intestinal resection, patients remain in the hospital for up to 10 days to undergo an early rehabilitation period without life-threatening complications.

Consequences of the operation

If the operation is performed endoscopically, then the risks of postoperative complications are quite small. The professionalism of the doctor and the patient’s discipline in preparing and following subsequent recommendations plays a key role in recovery.

The main complications of operations are:

Secondary infection;
Development of internal bleeding and anemia;
Intestinal obstruction;
Perforation of the intestinal walls;
Formation of fecal stones.

A dangerous complication is the malignancy of the remaining polyp tissue, which can be left behind during gentle techniques. Unfortunately, any operation does not guarantee a complete cure for intestinal cancer and recurrence of polyposis. Often, over time, benign cells stop differentiating from malignant ones.

Features of the postoperative period

The postoperative period is the basis for the patient’s successful recovery. Rehabilitation is aimed at eliminating relapses, infection, and monitoring the condition of the mucous membranes.

After surgery, it is important to carry out regular:

Ultrasound examinations,
MRI (which is better: colonoscopy or MRI),
virtual colonoscopy (what is virtual colonoscopy),
irrigoscopy (at least 2 times a year).

Attention! An important aspect is the analysis of the histological examination of the removed growth. The research method allows us to exclude the oncological nature of the disease.

How long does it take for a wound to heal?

After removing the polyp and cauterizing it, the wound surface heals in just a few days, thanks to the cells’ ability to regenerate. Surgical sutures take longer to heal when the manipulation was performed through incisions in the abdominal cavity. External seams are regularly treated with an antiseptic, and daily dressings are performed.

If healing is successful and there are no post-operative complications, the scars will heal within 14 days.

In addition to recommendations for periodic examination of the intestines for relapse, an important aspect is the organization of therapeutic nutrition and stabilization of stool.

Patients should limit their intake of the following foods:

salt and salt-containing products;
flour and confectionery products;
preservation, marinades;
fried food, fast food.

All dishes are best boiled, stewed or steamed. In the first month after surgery, dishes should be ground through a sieve to maximize the unloading of the gastrointestinal tract.

Sample menu for the week:

Monday: For breakfast - dairy-free slimy porridge with crackers; for lunch - steamed fish and mashed potatoes; for an afternoon snack - jelly; for dinner - stewed cabbage, apple.
Tuesday: Breakfast - tea with crackers; for lunch - noodle soup with chicken broth; for an afternoon snack - a glass of kefir; for dinner - boiled chicken 150 g with tomato.
Wednesday: In the morning - milk noodle soup, tea; for lunch - pilaf with chicken; for an afternoon snack - bread with milk; for dinner - rice porridge.
Thursday: Breakfast - warm green tea with a bun; for lunch - chicken broth with crackers, vegetable salad with sour cream; for an afternoon snack - any fruit; for dinner - stewed cabbage with meat and tomato juice.
Friday: Breakfast - weak cranberry juice with bread; for lunch - soup with meatballs and fresh cabbage salad with cucumber, olive oil; for an afternoon snack - jelly; for dinner - beef chop with tomato.

On weekends, you can resort to fasting days on chicken and drinking plenty of fluids: berry juice, compotes, rosehip decoction, green tea. This will not only reduce the load on the gastrointestinal tract, but also slightly reduce excess weight.

Removing polyps is a serious operation, regardless of the extent of the intervention. Compliance with all the doctor’s requirements will speed up recovery, as well as reduce the risks of unwanted consequences.